体外循环对瓣膜置换术病人血液流变学的影响

INFLUENCES OF CARDIOPULMONARY BYPASS ON HEMORHEOLOGY IN PATIENTS UNDERGOING CARDIAC VALVE REPLACEMENT

目的 :探讨体外循环灌注管理方法对瓣膜置换术病人血液流变学的影响。方法将 2 0例行瓣膜置换术患者随机分两组 , 组 (10例 )用心脏跳动中心内直视术的体外循环管理方法 ; 组 (10例 )采用浅低温冷血停跳液间断灌注的体外循环灌注管理方法。在转流前 ,转机中复温开始时及停机后 1h,分别采血测定分析血液流变学指标。结果 :转流期间和停机后 1h,两组的血液黏度、红细胞压积及红细胞聚集指数均下降 (P <0 .0 5 ) ; 组的红细胞刚性指数在转流期间高于转流前 (P <0 .0 5 )。结论 :用心脏跳动中心内直视术的体外循环管理方法 ,易保持良好的生理状态 ,保证微循环灌注和组织氧供。

Objective: To evaluate the effect of perfusion management on hemorheology during cardiopumonary bypass (CPB)in patients undergoing cardiac valve replacement Method:20 patients undergoing cardiac valve replacement were randomly divided into two groups: Ⅰ(n=10) and Ⅱ(n=10) Routine CPB perfusion management for cardiac valve replacement in beating heart was used in group Ⅰ; intermittent CPB perfusion with light hypothermia cold-blooded cardioplegia was applied in groupⅡ Before CPB, during CPB and one hour after CPB, the changes of hemorheology were measured Result: In both group the whole blood viscosity, the whole blood reduced viscosity ,plasma viscosity, hematocrit , erythrocyte sedimentation equation K and erythrocyte aggregation index decreased during CPB and one hour after CPB (P <0 01);In group Ⅱ, erythrocyte rigidity index increased during CPB comparing with that before CPB (P<0 05) Conclusion: Perfusion management for open heart operation in beating heart can keep physiological state stably, which maybe contributes to microcirculation perfusion and tissue oxygen suppling